Certifying deaths due to post-acute sequelae of COVID-19 In the acute phase, clinical manifestations and complications of COVID-19 of varying degrees have been documented, including death. However, patients who recover from the acute phase of the infection can still suffer long-term effects (8). Post-acute sequelae of COVID-19 (PASC), commonly referred to as “long COVID,” refers to the long-term symptoms, signs, and complications experienced by some patients who have recovered from the acute phase of COVID-19 (8–10). Emerging evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, can have lasting effects on nearly every organ and organ system of the body weeks, months, and potentially years after infection (11,12). Documented serious post-COVID-19 conditions include cardiovascular, pulmonary, neurological, renal, endocrine, hematological, and gastrointestinal complications (8), as well as death (13).
Consequently, when completing the death certificate, certifiers should carefully review and consider the decedent’s medical history and records, laboratory test results, and autopsy report, if one is available. For decedents who had a previous SARSCoV-2 infection and were diagnosed with a post-COVID-19 condition, the certifier may consider the possibility that the death was due to long-term complications of COVID-19, even if the original infection occurred months or years before death. If it is determined that PASC was the UCOD, it should be reported on the lowest line used in Part I with the condition(s) it led to on the line(s) above in a logical sequence in terms of time and etiology. If it is determined that PASC was not the UCOD but was still a significant condition that contributed to death, then it should be reported in Part II. Certifiers should use standard terminology, that is, “Post-acute sequelae of COVID-19.” See Scenario IV in the Appendix for an example certification. In accordance with all death certification guidance, if the certifier determines that PASC did not cause or contribute to death, then they should not report it anywhere on the death certificate.
Author(s): National Vital Statistics System, National Center for Health Statistics
Methods—Data are based on 99.94% of all 2021 birth records received and processed by the National Center for Health Statistics as of February 10, 2022. Comparisons are made with final 2020 data and earlier years.
Results—The provisional number of births for the United States in 2021 was 3,659,289, up 1% from 2020 and the first increase in the number of births since 2014. The general fertility rate was 56.6 births per 1,000 women aged 15–44, up 1% from 2020 and the first increase in the rate since 2014. The total fertility rate was 1,663.5 births per 1,000 women in 2021, up 1% from 2020. Birth rates declined for women in age groups 15–24, rose for women in age groups 25–49, and was unchanged for adolescents aged 10–14 in 2021. The birth rate for teenagers aged 15–19 declined by 6% in 2021 to 14.4 births per 1,000 females; rates declined for both younger (aged 15–17) and older (aged 18–19) teenagers. The cesarean delivery rate rose to 32.1% in 2021; the low-risk cesarean delivery rate also rose to 26.3%. The preterm birth rate rose 4% in 2021 to 10.48%, the highest rate reported since 2007.
Author(s): Brady E. Hamilton, Ph.D., Joyce A. Martin, M.P.H., and Michelle J.K. Osterman, M.H.S., Division of Vital Statistics, National Center for Health Statistics
The CDC’s National Vital Statistics System (NVSS) provides monthly provisional data on predicted total drug overdose deaths during the preceding 12 months. The most recent data reflect September 2019 through August 2020. During that period, there were 88,295 predicted deaths, a record high that is almost 19,000 more deaths (27%) than the prior 12-month period.
Using these predicted data in combination with final data from 2019, we estimated monthly overdose deaths from January to August 2020. Our estimates show that total overdose deaths spiked to record levels in March 2020 after the pandemic hit. Monthly deaths grew by about 50 percent between February and May to more than 9,000; they were likely still around 8,000 in August. Prior to 2020, U.S. monthly overdose deaths had never risen above 6,300.